Comment by mtlmtlmtlmtl
8 hours ago
This is the first I'm hearing about anti-NMDA receptor encephalitis; what a strange and scary condition. If you don't mind the prying, I'm curious about some things.
I noticed you said in another comment that you were treated with antipsychotics in the psych ward. Would you say they had any effect in lessening the symptoms? My intuition says no, since I'm not aware of any conventional antipsychotics that interact with NMDA receptors directly(mostly they act on dopamine and serotonin receptors), but psychopharmacology is tricky that way...
And, another thing. Have you ever tried dissociative drugs(like ketamine, PCP, DXM), and if so, how similar would you say your experience was to those drug experiences? Of course, feel free to tell me to fuck off if you don't want to discuss that in a public forum.
Prying is great. Ask away.
> I noticed you said in another comment that you were treated with antipsychotics in the psych ward. Would you say they had any effect in lessening the symptoms?
Your intuition is right. The antipsychotic was actually prescribed by a psychiatrist during my second hospital stay at Brigham and Women's and not at a psych ward. (I would later enter another psych ward where the psychiatrist there prescribed a different antipsychotic and took me off of the old one.) I essentially begged for it because I wanted something that would help me that wasn't Ativan. Ativan helped a lot, but I was so concerned about it being a benzo and getting addicted to it. I wanted it to help me sleep too. The antipsychotic was prescribed in the window of time where they thought it was MS. I hadn't gotten the positive antibody test result back yet.
I'm being a bit vague here in terms of why I wanted it. I don't mind going into more detail personally, but it gets extremely dark and extremely intense very fast. I don't know if that's something I want to publicize yet. As bad as my OP sounds, it was in fact way worse.
> And, another thing. Have you ever tried dissociative drugs(like ketamine, PCP, DXM), and if so, how similar would you say your experience was to those drug experiences? Of course, feel free to tell me to fuck off if you don't want to discuss that in a public forum.
I have not. The hardest drug I've ever done was a few puffs from a vape pen of marijuana about 6 years ago. Otherwise, before the encephalitis, I would say I was a moderate consumer of alcohol and tobacco (via cigars, not cigarettes). Once the encephalitis started (early March) I went cold turkey on both alcohol and tobacco and did not suffer any withdrawal effects AFAIK. (This was a question asked by many doctors, many times, repeatedly. I was always proud to give a consistent, "Zero alcohol since March N. Zero cigars sinces March N.")
Prior to that I had considered trying LSD some day. After this, not a fucking chance.
Thanks for the detailed answers.
I can understand being hesitant about sharing the details of why you wanted the antipsychotics. It sounds like this is your first(hopefully last!) brush with psychotic/dissociative states of mind. Though I can't pretend to know what it was like for you, I can tell you I've been in similar situations. I've had several cases of acute psychosis caused by drugs(sometimes stimulants, sometimes synthetic cannabinoids) and/or sleep deprivation in the past. I also experimented heavily with all manner of psychedelic and hallucinogenic drugs in my early 20s, and I'm a severe hashish addict(currently 2.5 years in remission thanks to a moderation oriented treatment program I designed myself). It can be profoundly and existentially scary. You encounter parts of your psyche that you may never have met before, and reality breaks apart at the seams. You truly learn the extent to which your perceptions, thoughts, and even intentions are at the whims of implementation details in your brain. If you want, I could share some concrete anecdotes from my own experiences. But the main thing I want to say is give it time. These things must be processed, and it takes time, but it will get easier. And in time you will emerge with a better understanding of what it is to be human, and of yourself.
As to your comment on LSD, I support that. Sanity is taken for granted, until you temporarily lose it. If at some point you change your mind on exploring psychedelics, my advice would be to ditch LSD and go with psilocybin mushrooms instead, for a number of reasons.
Psychedelics very rarely cause actual psychosis, but LSD should have a higher risk than most, because unlike psilocin(the active compound in mushrooms, which psilocybin is converted into), LSD has non-trivial activity at dopamine receptors, and importantly the D2 receptors. LSD is in some sense the opposite to an antipsychotic in that it acts on the same receptors as antipsychotics, but with an opposite effect. Drugs that act as agonists on D2 receptors(usually Parkinsons meds) are well documented to cause psychosis in some people, as are stimulants like amphetamine which increase synaptic dopamine levels.
Psilocybin mushrooms are also pretty safe in that as long as you've identified the mushrooms correctly, you know what's in them. LSD on the other hand, more often than not is not actually the "original" LSD these days, but some LSD analogue. Usually it'll be something very similar in structure and effect to LSD, but it'll still be poorly studied compared to LSD. There are also drugs which are substantially different from LSD being sold on blotter paper as LSD, and some of these can be quite toxic(25i-nbome), extremely long lasting(DOB, DOM), or both(bromo-dragonfly).
Psilocybin is also free of course, since it's bound to be growing someplace near you in vast amounts, though the specific species depends on where you live.
And finally, it's much easier to take psilocybin in small doses. I always recommend people do this when trying psychedelics for the first time. Try a sub-threshold dose first, just enough to feel a little "weird". See how it feels, decide whether to do more next time, or stop, etc. It's possible to this with LSD, but it's much trickier, because LSD usually comes on this tiny little blotter paper. You can cut it up into smaller pieces, but there's no guarantee the drug is evenly distributed across the paper, and it's also impossible to be completely sure how much drug is on the blotter in the first place, unless you made them yourself. Mushrooms on the other hand are usually measured in grams; much easier.
But yeah, I'm not recommending you do psychedelics. Especially not any time soon, while you're still healing. It's always good to have a stable baseline before you go stirring the pot, so to speak.
Thanks for the thoughtful response. There isn't a world in which I touch psychedelics voluntarily. Like is it possible if I existed in a vacuum? Maybe. But I couldn't take that risk, no matter how small, and do that to my family.
Thankfully it was only ever a passing curiosity for me. A bucket list kind of thing. I am now very happy to replace with many other amazing experiences I hope to have. :-)